Obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) are mental health disorders that share similar names, so distinguishing between the two can be challenging. However, the clinical definitions of these disorders are different.
People with OCD have obsessive, intrusive, repetitive thoughts, known as obsessions. They may feel compelled to repeat behaviors, which are known as compulsions. With OCPD, a person may be excessively focused on order and perfection.
Understanding the differences between OCD and OCPD can help determine what treatment is needed.
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Symptoms of OCD vs. OCPD
OCD and OCPD may overlap in terms of similar thought patterns and behaviors. They may also share similarities involving order, perfectionism, and organization. However, only OCD is characterized by true obsessions and compulsions.
Traits of OCD
OCD is mainly characterized by obsessions and compulsions that are time-consuming and cause distress to the person with OCD.
Obsessions present as repeating thoughts, worries, or even mental images that are intrusive, unwanted, and unrelenting.
Compulsions present as repeating behaviors that a person feels driven or urged to perform. This repetition is often done to avoid anxiety or a perceived risk, such as excessive handwashing to avoid the risk or fear of germs.
People with OCD are typically aware that they have a disorder, though people with OCPD may not be.
Traits of OCPD
OCPD is characterized differently than OCD. People with OCPD are strongly focused, almost obsessively so, toward a goal of perfection for themselves and others and toward maintaining rules and order in their environment.
People with OCPD may exhibit the following traits:
- High-achieving, conscientious, and function well at work
- Face challenges understanding others’ points of view
- Have difficulty hearing constructive criticism
- Look for patterns of control and order
- Desire perfectionism to the point that this strong urge interferes with actually completing tasks
- May have tendencies toward being unable to discard old or valueless objects
Consistency of Symptoms
OCD is a disorder based on fear, anxiety, and efforts to control uncertainty. The obsessions and compulsions may ebb and flow based on the person’s current level of anxiety or fear. OCPD, however, is a personality disorder, so the behaviors don’t tend to fluctuate. Rather, they occur more consistently over time.
Causes of OCD and OCPD
While the exact causes of both OCD and OCPD are not yet fully understood, there are several possible factors.
OCD Risk Factors
- Neurological factors: OCD may result from disruptions in communication between certain regions of the brain. Other studies suggest that abnormalities in neurotransmitters such as serotonin may be a significant factor in OCD.
- Genetics: Studies have shown a genetic factor to OCD, in that individuals with a family history of OCD are more likely to have the condition.
- Stress and environment: Incidents like brain injury, infection, trauma, and stressful events can contribute to the development of OCD. Stress can both prompt and exacerbate the symptoms of OCD.
- PANDAS: A reaction to streptococcal infection (the same type of bacteria that causes strep throat) during childhood can sometimes cause inflammation in the brain which can lead to the development of OCD. These types of cases are called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections).
OCPD Risk Factors
- Genetics: OCPD appears to have a genetic component. Studies have found that OCPD is more likely in individuals who have a family history of the condition.
- Early attachment: One study indicates OCPD may start in childhood from disruptions to attachment bonds. For example, if a child is unable to form a bond with a primary caregiver during childhood, it can impact later relationships and create attachment difficulties. Personality disorders form to help the person cope with the attachment injury.
Diagnosis
Mental health experts diagnose OCD and OCPD using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association’s official handbook, to diagnose mental health conditions.
Diagnosing OCD
To diagnose OCD, a clinician will use the DSM-5 to determine the following:
- If obsessions or compulsions (or both) are present
- If the obsessions and/or compulsions are occurring because the person is trying to prevent anxiety, distress, or a potential situation
- If the obsessions and/or compulsions are excessive, and these thoughts and/or behaviors are taking up considerable time in the person’s life (more than one hour a day) or causing distress
- If the obsessions and/or compulsions impair the individual’s ability to function socially or at work
Diagnosing OCPD
To diagnose OCPD, a clinician will use the DSM-5 to examine the following traits:
- A constant pattern of order and control that can come at the expense of flexibility, efficiency, and openness
- Perfectionism that may interfere with being able to complete a task, especially when the person’s standards are not being met
- A preoccupation with details, rules, order, organization, and schedules to an extreme degree
- An excessive devotion to work outside of a financial need, even forsaking personal relationships in favor of work
- Significant difficulty with flexibility when it comes to their own ideas and their plan for how to complete tasks
Treatment
OCD and OCPD are often treated in similar ways. In both cases, medication and talk therapy (or a combination of both) will help treat OCD and OCPD.
OCD Treatment
People with OCD may be prescribed selective serotonin reuptake inhibitors (SSRIs), which have been shown to help treat OCD. SSRIs are often the first-line treatment for OCD.
Psychotherapy can also be used to treat OCD, including:
- Cognitive behavioral therapy (CBT): CBT helps people understand how their thoughts (particularly negative ones) influence their behavior and how to react differently.
- Exposure and response prevention (ERP): ERP exposes someone to the triggers causing their obsessions and assists them in overcoming the need for their compulsions.
OCPD Treatment
Treatment for OCPD has not been well-researched, with only a few small studies to date.
At this time there are no specific medications for OCPD, although the same medications that help treat OCD (SSRIs) can also help with OCPD.
Small research studies suggest that CBT is also effective in treating people with OCPD, because it can help them examine their thoughts and the actions that follow.
Prevention
When biological factors, such as genetics, are at play, it may not be possible to prevent OCD or OCPD. However, there may be some interventions that can mitigate the environmental contributions to these conditions.
Early intervention may also be the key in reducing the severity of the conditions. Education and improving access to effective treatments can help.
Coping
People with OCD are frequently distressed by the excessive and repeating thoughts and behaviors they experience. It can be time-consuming to repeat behaviors and can impact a person’s social functioning. These behaviors can affect those around them as well.
There are support groups available for people with OCD and their loved ones. Connecting with people who have similar experiences can help.
Many people with OCPD are not aware that they have a disorder or the effect it has on the people around them. This can make it especially difficult to seek help. If you notice symptoms of OCPD, speak with a mental health professional about a screening.
Seek Help
If you or a loved one is struggling with OCD or OCPD or both, you can contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline online or call 800-662-4357 for more information on how to find support and treatment options specific to your geographic area.
For more mental health resources, including a helpful list of links and hotline numbers, see our National Helpline Database.
A Word From Verywell
OCD and OCPD are separate conditions, but both are treatable through similar methods. It’s important to seek help from a mental health professional or healthcare provider when noticing symptoms to achieve an accurate diagnosis of OCD or OCPD.
Frequently Asked Questions
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The most significant difference between OCD and OCPD is that OCD is classified as an anxiety disorder and OCPD is classified as a personality disorder.
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People with OCD tendencies may experience anxiety. OCD is classified as an anxiety disorder.
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A person can be diagnosed with both OCD and OCPD. OCPD occurs in people with OCD 15%–28% of the time.